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[Treatment of malaria in children in France]
1Service de pédiatrie générale et néonatologie, hôpital Saint-Vincent-de-Paul, Paris, France.
Insights
Most malaria cases in France involve Plasmodium falciparum resistant to chloroquine. Recommended treatments for uncomplicated malaria include quinine, mefloquine, or halofantrine, with halofantrine preferred for children.
Area of Science:
- Tropical medicine
- Infectious diseases
- Pharmacology
Context:
- Increasing prevalence of Plasmodium falciparum malaria in France.
- Widespread chloroquine resistance in malaria-endemic regions.
- Need for effective treatment strategies in non-endemic settings.
Purpose:
- To outline current treatment guidelines for Plasmodium falciparum malaria in France.
- To address the challenges posed by drug resistance.
- To highlight critical factors influencing the prognosis of cerebral malaria.
Summary:
- Oral quinine, mefloquine, or halofantrine are recommended for uncomplicated malaria.
- Halofantrine is the preferred treatment for children regardless of age.
- Prompt diagnosis and risk factor identification are vital for cerebral malaria prognosis.
- Quinine infusion, guided by pharmacokinetics, is the standard treatment for cerebral malaria.
Impact:
- Provides evidence-based recommendations for clinicians managing malaria in France.
- Informs public health strategies for combating drug-resistant malaria.
- Aims to improve patient outcomes, particularly in severe cases of cerebral malaria.
Abstract:
Currently, most of the subjects presenting with Plasmodium falciparum malaria in France come from areas where chloroquine resistance has already been reported. Treatment of uncomplicated malaria should consist of oral administration of either quinine or mefloquine or halofantrine. In children, halofantrine seems to be the treatment of choice at any age. The prognosis of cerebral malaria depends on how fast the diagnosis is made and the treatment is undertaken. The detection of clinical and biological risk factors is crucial. The treatment of cerebral malaria is based on quinine perfusion administered according to pharmacokinetic data.